MLA vs Endotracheal intubation

[arytmica]

Hey there
One year ago we changed our guidelines from endotracheal intubation to MLA/Larynx mask The reason was that the MLA is faster to apply and also that endotracheal intubation requires frequent training. There's a disagreement about this... Some people like the MLA, it's fast and easy, and some prefere the old school intubation. Anyway, the MLA ain't an 100% secure airway, and I think that's what bothers the most of my colleagues. My experience about the MLA is that it's working good most of the times, but sometimes it happens to be some air-leak which makes it hard to preform good ventilations. What's your oppinion about this? Do you use endotracheal intubation, MLA or both in your orgaiosation?

What do you think about the different tools?

(This is an MLA/Larynx mask) Don't know if it's called the same in your country?

[chbare]

It's called an igel in the United States. The issues you report are not unique to this style of airways. It might be interesting to go back and look at every airway inserted over the past year and identify good and bad experiences, then compare this with intubation data from past years. This would give you a better system wide appreciation as opposed to anecdote.

[arytmica]

I've read some studies about it, and the results shows that the Igel/MLA is faster, easier and more time-effective compared to the endotracheal intubation, but some studies shows that the endotracheal intubation in cardiac arrest situations was associated with increased survival. But noone could tell exactly why.

[chbare]

There are also studied that show intubation or any advanced airway procedure is associated with decreased survival.

[arytmica]

Yep

[island emt]

We had the LMA about a decade ago. We found that while insertion is easy , it does not prevent aspiration and is very hard to keep in securely place as your bouncing down rural roads.

We changed to the King LTD as a more positive airway control and once inserted it stays put and prevents aspiration.